The Nurse Stress Index (NSI) was developed in 1989 by P. E. Harris to evaluate the perceived sources of work-related stress for nurses with managerial responsibilities and those in charge of nursing and nurses. While historically work-related stress for nurses was measured by staff morale, job performance, absence, and turnover, this scale focuses on other domains for work-related stress.
The NSI is a 30-item self-report instrument that consists of six sub-scales, each of which measures a different domain of work-related stress. Each domain is described below. Note that there are two domains of “managing workload”–Domains 1 and 2.
|Domain 1 and 2: Managing Workload||Measures pressure due to feelings of insufficient time and resources to complete tasks and meet deadlines||
I have too little time in which to do what is expected of me.
The demands of others for my time at work are in conflict.
I spend my time fighting fires rather than working to a plan.
|Domain 3: Organizational Support and Involvement||Assesses the pressures perceived due to lack of involvement in planning and decision-making at work and issues concerning inadequate, or lack of, feedback||
I only get feedback when my performance is unsatisfactory.
Decisions or changes that affect me are made above, without my knowledge or involvement.
Management misunderstands the real needs of my department.
|Domain 4: Dealing with Patients and Relatives||Evaluates the patient’s and family’s relationship with the nurse and the nurse’s feelings about required patient care, ethics and death and dying||
I am involved daily in life or death situations.
I am dealing with aggressive patients and families.
|Domain 5: Home-Work Conflict||Measures stresses due to the conflicting demands of work and personal life||
I need to absent myself from work to cope with domestic problems.
My superiors do not appreciate my home pressures.
My family demands inhibit promotion.
|Domain 6: Confidence and Competence in Role||Measures the difficulties experienced by nurses with the role that they are required to fill, including coping with change and responsibility||
I don’t feel adequately trained for the job I have to do.
I have uncertainty about the degree or area of my responsibility.
I have not been trained on new technology.
Authored by Elsie Crowninshield, RNP, DNP, CCRN, NE-BC and Adele Webb, Ph.D., RN, FNAP, FAAN